Thursday, December 10, 2009

The next stage
Once your baby is happy eating from a spoon, increase the range of foods you offer to include:

• purees of lentils or legumes such as sweet peas; • purees of mixed vegetables with potatoes or rice; • purees which include leafy green vegetables, such as cabbage, spinach, bayam, siew pak choy or kailan;

Try to limit the number of sweet or cereal purees to one a day, and always include a vegetable puree. Gradually make the food a thicker consistency.

Your paediatrician may recommend that you wait at least six months to introduce soya beans, fish and citrus fruits;wait one year to introduce eggs and cow's milk or milk products (cheese and yoghurt);two years to introduce shellfish
If your family has a history of allergies, such as eczema, asthma or food allergies, your baby should avoid peanuts and sesame seeds up to the age of three years.
The risk of developing coeliac disease is reduced by avoiding foods containing gluten, such as wheat, rye and barley-based foods. That includes bread, flour, pasta, some breakfast cereals and rusks until six months. Oats are best avoided until six months, too, in case they contain traces of gluten.
Avoid follow-on milk until after your baby is six months old. Don't add salt or sugar, honey or other sweeteners to your baby's food.

From seven to nine months

From now your baby's ability to join in with family meals increases enormously. Seat him, in a highchair, at the dinner table when the family is taking meals.
Even if your baby has an earlier mealtime than the rest of the family, it is important that he gets used to having meals in his highchair, especially now that he is becoming mobile. Babies who are in a recline or semi-recline position and toddlers who are allowed to run about with food in their mouths are at increased risk of choking!
You should offer your baby a wide range of foods to fulfil his nutrient requirements, and to get him used to eating different flavours. There are also fewer foods to avoid.

Now's the time to introduce:
• Mashed or minced food, not purees. Be sure to include some lumps.
• A wider range of starchy foods -- bread, pasta, pita bread, thosai, breakfast cereals, oats, in addition to soft mee or meehoon, potatoes, rice and millet. Give two to three servings a day of starchy foods.
• Cooled boiled water from a beaker with a soft spout, when she is thirsty, in addition to her daily breastmilk or 500-600mls/ 17-20oz of formula. If you do choose to give fruit juice, keep it to mealtimes only and dilute it 1 part juice to 10 of cooled boiled water, and use a beaker or feeding cup, not a bottle. Keeping juice to meal times helps with iron absorption and reduces the risk of damage to emerging teeth.
• Citrus fruits such as oranges.• Eggs which are well cooked, fish and lentils. Aim for one serving of protein-rich food a day.
•Dairy products, such as yoghurt and cheese. Although you should wait until one year to introduce cow's milk as a drink, it can be used in cooking or in your baby's breakfast cereal, so make a cheese sauce to add to vegetables or pasta.
• Follow-on formula can be used if you wish.
• Finger foods are great once your baby can hold things, and allow her a degree of control. Try cooked green beans or carrots, cubes of cheese, slices of banana or soft pear.

From 10 months
Meals should be more adult-like now. They should be chopped or minced and follow a two to three meal a day pattern along with one or two snacks and 500-600mls/ 17-20oz of breastmilk or formula milk. At this stage your baby should be having:
• three or four servings of starchy foods, such as rice, mee, bread, pasta or potatoes, a day
• one serving of meat, fish, eggs, or two of pulses (lentils, peas, beans)
• one to two servings of cheese or yoghurt as well as breastmilk or formula milk.

What should babies under one year avoid?
• Still keep off salt, sugar, honey and artificial sweeteners. Try sweetening desserts with mashed banana or a puree of stewed dried fruit if possible, or use expressed breastmilk or formula milk.
• Avoid the temptation to add a little tea to baby's bottle. The tannin in tea interferes with iron absorption, and the caffeine it contains is not recommended for children.
• Avoid giving fruit squashes or diet drinks to your baby. Artificial sweeteners are not suitable for babies and young children.
• Avoid foods which may carry a risk of food poisoning, such as soft mould-ripened cheeses (brie, camembert) and liver pate. Eggs must be properly cooked – avoid giving soft-boiled, half-boiled or raw eggs.
• Don't give cow's (or goat's or sheep's) milk as a main drink under one year.
• Skimmed and semi-skimmed milks, low-fat spreads, yoghurts and reduced-fat cheeses. Always offer your baby the full-fat versions -- they need the calories.

How much fat should babies and toddlers have?
Up to the age of at least two, fat is an important source of energy for your baby, so full-fat versions of milk, cheese and yoghurt are important. When she is two, and only if she is growing well, and eats a well-balanced diet, you can gradually introduce lower-fat versions. By the time she is five years old, only about a third of her energy should be provided by fat.

How much fibre?
Be cautious about introducing too many wholegrain foods and pulses for babies and young children. These tend to be bulky and can fill up a small tummy, leaving little space for other higher energy foods. So give your baby and toddler a mixture of white and wholegrain bread, rice and pasta as well.

The Health Ministry recommends exclusive breastfeeding until your baby is six months old. After six months, breastmilk alone doesn't provide your baby with enough nutrients, in particular iron, so other foods are needed.
Waiting until six months to introduce solid foods into your baby's diet will help minimise the risk of her developing adverse reactions to foods and allergies. This is particularly important if you have a family history of allergies, as the incidence of adverse food reactions, allergies and coeliac disease does decrease if you delay weaning until this time.
If you feel your baby needs to start solids before six months, do discuss it with your paediatrician first. This is particularly important if your baby was born prematurely. If you do decide to wean your baby onto solids before six months, there are a number of foods that need to be avoided, such as those containing gluten, eggs, cheese, dairy products, fish and shellfish and nuts.

Is my baby ready to start solids?
Your baby may be ready to start solids if she:

•can hold her head up - baby pms dah kuat hold her head masa 4 bulan lagi rasanya
It's important that your baby is able to maintain a steady, upright position in order to take first foods from a spoon.
• sits well when supported - dah boleh duduk sendiri masa 5 bulan 3minggu
You may have to support her initially. Try propping her up on the corner of your sofa or lean her against another adult. A highchair can be pulled into action a bit later when she's able to sit up all by herself.
• makes chewing motions - dah kunyap2 biler tgk ibu dan abah makan..hehehe
Your baby should be able to move food to the back of her mouth and swallow. As your baby learns to swallow efficiently you may notice her drooling decrease.
• has gained a healthy weight - 6 month dia 7kg++
Most babies are ready to eat semi-solids when they've doubled their birth weight, which may take place before or around their sixth month. If your baby seems underweight, check with your paediatrician.
• displays curiosity about what you're eating - pandang tak lepas tgk ibu dan abah makan...
Your baby begins eyeing your meals and reaches out to try foods travelling from plate to mouth.

How should I begin to introduce semi-solids?

Our local expert recommends that you offer your baby two to three teaspoons of cereal mixed with her usual milk to make a 'soupy' solution. The Health Ministry recommends homemade porridge, infant rice cereal and cooked mashed or pureed vegetables or fruits as a starter food. Give this to your baby on a soft rubber-tipped spoon. Then offer her the rest of the milk. It doesn't have to be the morning feed; pick a time that's convenient for both you and your baby.
As your baby gets used to the new texture and consumes more and more solids, she will need less milk to fill her up. However, at first, your baby will seem to eat very little, and it may take a while to get even that small amount into her. Do be patient with your little one and remember it may take a little time for her to learn these new skills.
When your baby is eating two to three tablespoons of cereal a day, try adding another food. As she begins to eat and develops more of a side-to-side grinding motion, add a little less liquid so the texture becomes thicker. This allows your baby to work on chewing (gumming) and then swallowing.
Your baby's appetite will vary from one feed to the next, so watch for cues that she's full. A baby who refuses to open up for the next bite, turns away, or starts playing with her food is probably full.

Do I still need to breastfeed?Yes.Breastmilk is designed to be the perfect food for your baby's first six months. Both breastmilk and formula provide important vitamins, iron, and protein in an easy-to-digest form. Even though solid foods will gradually replace some of your baby's milk feeds, breastmilk or formula will remain her most important source of nutrition until she is one year old. In fact, the Health Ministry recommends that breastmilk remain a part of your baby's diet until she is two.

How can I help my baby develop healthy eating habits?
You can help your baby learn to eat well by following these simple rules:
• Offer a varied selection of foods.
• Don't try to keep feeding your baby once she has lost interest in the food (turns her head away or keeps her mouth closed). She may be full or simply dislike the food. If you are too persistent, you may put her off trying other foods.
• Give your baby a variety of protein and carbohydrate food, fruits, and vegetables.
• Avoid sugar, salt, and very fatty foods or hot, spicy foods.
• Don't bribe or reward your child with food. Instead, offer her plenty of hugs, kisses, and attention.

How should I introduce more solid foods?
New foods should be introduced slowly, one at a time. Your baby needs time to get used to each new taste and texture. Also, careful introduction of different foods will allow you to watch for signs of a possible allergic reaction, such as diarrhoea, tummy aches, or rashes. Try adding one new food every few days, starting with yellow fruits and vegetables, which are easy for babies to digest. Some experts advise beginning with green veggies, as babies can sometimes get fixed on the sweeter taste of fruits and yellow vegetables and may not give peas and beans a fighting chance!
Start by offering your baby a few tablespoons of fruit or vegetables in the same meal as a cereal feed. Good foods to start with: ripe pureed apple, bananas, papaya, mangoes, carrots, peaches, pears, sweet potatoes, cauliflower and pumpkin. Try mixing to a sloppy consistency with boiled, cooled water or breast or formula milk. You can also try baby rice or plain porridge
If your baby refuses the food, offer it again a few days later. She may always turn up her nose at some foods, but continue to offer them in hope that they become more appealing.

How many times a day should my baby be eating solid foods?
By the time your baby is about seven months old, she should be eating semi-solids three times a day. A typical day's intake may be:
• Breastmilk or iron-fortified formula. Small amounts of unsweetened juice well diluted with boiled, cooled water (one part juice to ten parts water), can also be given with meals only in a feeding cup or beaker, not a bottle.
• Iron-fortified cereal
• Plenty of vegetables, such as potatoes, broccoli, cauliflower, sweet potato, choy sum, kailan, siew pak choy and spinach
• Small amounts of meats, poultry, fish, yoghurt, hard-boiled eggs, well-cooked lentils, cheese (except brie, stilton and other mouldy or soft cheeses)
• Fruit

Some general guidelines apply:
• Don't give honey until age one because it can carry a small risk of infant botulism.
• Depending upon your infant's diet, vitamin drops may be recommended. Ask your paediatrician for more advice.

What about finger foods?
As baby grows more experienced, you can increase the thickness of the foods offered to include chunkier soft lumps and mashed foods. At about seven to nine months your baby may be ready for finger foods cut into bite-sized bits. (Many babies won't have enough control of their fingers and hands until they are closer to nine months or even older.)
Some ideal first finger foods that can be easily gummed and digested are: bread, ripe bananas, tender cooked carrots and sweet potatoes, rice crispies or rice puffs and cooked pasta shapes. Never leave your baby alone when eating because of the risk of choking.
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